Enhancement of electromagnetically induced absorption with elliptically polarized light--laser intensity dependent coherence effect.

Using the (2)S(1/2)F(g) = 2 --> (2)P(3/2)F(e) = 3 transition in (87)Rb vapor at room temperature, we study effect of the laser light polarization on the electromagnetically induced absorption (EIA). This work extends the recent study of the behavior of the EIA as a function of the laser ellipticity (Brazhnikov et. al., JETP Lett. 83, 64, 2006). We have shown that such behavior strongly depends on the laser power. For the low laser power EIA amplitude has maximum for linearly polarized light, while for high laser power elliptically polarized light of ellipticity 15-20 degrees generates maximum of the EIA amplitude. EIA width varies slowly with the laser ellipticity at lower laser power, and much stronger at higher laser power. Through our theoretical model we attributed observed results to combined effect of the laser ellipticity and power on the population of ground state Zeeman sublevels.

Asymptomatic microscopic haematuria in young males.

AIM: The study involved 120 young males (aged 20.5 +/- 2.5 years) having undergone successful kidney biopsy because of asymptomatic haematuria with the aims to assess the prevalence of histological diagnosis and the natural history of the disease. METHODS: The patients were selected from the population of conscripts who were referred to our clinic as a result of asymptomatic microhaematuria. All patients had a negative history of kidney disease, normal creatinine clearance (Ccr), while extrarenal causes of microhaematuria were excluded. The patients were divided into a group of 62 patients with isolated microhaematuria (IMH; proteinuria < 0.3 g/day) and a group of 58 patients with asymptomatic microhaematuria and proteinuria (AMHP; proteinuria > 0.3 g/day). After kidney biopsy patients were monitored for 3-9 years. RESULTS: Normal biopsies and minor abnormalities were more frequent in IMH than in AMHP patients, who had IgA nephritis more frequently and significantly higher total pathohistological score. Based on the clinical and histological features, recommendations on patients' ability for military service were made. During the follow-up period, normal Ccr maintained in all patients. Macrohaematuria appeared in 42 patients and proteinuria worsened in eight patients (seven with AMHP). Urinary abnormalities disappeared in 20 patients with IMH and in eight with AMHP (p = 0.04). CONCLUSION: Minimal histological changes and disappearance of urinary abnormalities were more frequent in IMH than in AMHP patients. Kidney biopsy is useful only in patients with AMHP but it is not necessary in IMH patients.

On non-vanishing amplitude of Hanle electromagnetically induced absorption in Rb.

Amplitude and linewidts of the Hanle EIA, obtained from transmission of the laser locked to closed F(g) ? F(e) = F(g) +1 transitions in (85)Rb and(87)Rb, have maximum values at few mW/cm2. Amplitude of the EIA reaches steady value different from zero for higher laser intensities, even for laser intensities of 40 mW/cm(2). Theoretical model of EIA, for the same atomic system as in the experiment, show that the laser intensity, at which maximum of amplitudes and widths occur, depends on the laser detuning. For smaller laser detuning of a few tens of MHz, EIA has a maximum and then vanishes at higher laser intensities. For larger laser detuning of the order of hundreds MHz (but still in the range of Doppler broadening) amplitude of the EIA has very broad maximum and remains above zero for intensities above 40 mW/cm(2). Such theoretical results indicate that Hanle absorption peak remains in the experimental results, regardless of the laser intensities, due to Doppler effect.

Interferon alpha sensitisation induced fatal renal insufficiency in a patient with chronic myeloid leukaemia: case report and review of literature.

Renal dysfunction as a sequel to extended interferon alfa (IFNalpha) treatment in chronic myeloid leukaemia (CML) has been reported previously in six patients. An additional patient is presented with Philadelphia chromosome positive (Ph+) CML and nephrotic syndrome in whom initial renal insufficiency developed after only one month of low dose IFNalpha therapy. The renal biopsy showed a focal segmental mononuclear cell infiltration, basal membrane thickening, and deposits of immunoglobulins (IgG; IgAGM IC3). In spite of discontinuation of IFNalpha, renal function deteriorated and the patient died six months later. This case represents an instance of fatal kidney insufficiency as an untoward effect of sensitisation to the IFNalpha, confirmed by modified Coombs assay.

Influence of carvedilol on chronic renal failure progression in spontaneously hypertensive rats with adriamycin nephropathy.

BACKGROUND: In this study, the effects of carvedilol, antihypertensive (alpha-beta blocker) agent with antiproliferative and antioxidative properties, on slowing down of chronic renal failure (CRF) progression in spontaneously hypertensive rats (SHR) with adriamycin (ADR) nephropathy were examined. METHODS: Eighty adult (24 weeks) SHR were divided into four groups: CONTROL GROUP: 20 SHR; ADR group: 20 SHR treated with ADR (2 mg/kg i.v. twice in 20 days); ADR-C group: 20 SHR treated with ADR and with carvedilol (30 mg/kg/day); ADR-CC group: 20 SHR treated with carvedilol and captopril (60 mg/kg/day). Systolic blood pressure was measured every two weeks, renal blood flow (RBF), mean arterial pressure (MAP) and renal vascular resistance (RVR) were determined at Weeks 6 and 12, creatinine clearance and proteinuria at Weeks -3 (see measurements), 6 and 12. The rats were sacrificed at Weeks 6 and 12 after the second ADR injection. Glomerular sclerosis, tubulointerstitial and blood vessel changes were determined by semiquantitative scoring. RESULTS: Carvedilol decreased systolic blood pressure. It decreased RVR and MAP, and increased RBF significantly. Carvedilol also significantly decreased interstitial infiltration in the early phase of the study, slowed down the development of interstitial fibrosis and tubular atrophy and decreased blood vessel changes. The hemodynamic and morphological effects of carvedilol were associated with slowing down the CRF progression as well as a mild decrease in proteinuria. Captopril addition to carvedilol improved its effects especially on prevention of tubulointerstitial changes. CONCLUSIONS: Results of this experimental study showed beneficial effect of carvedilol and its combination with captopril on CRF progression, indicating that clinical studies are warranted.

[Microscopic polyangiitis]. / Mikroskopski poliangiitis.

Microscopic polyangiitis is a very rare disease characterized by the lesions of arteriolae, venulae and capillaries--mainly of the kidneys and lungs, but also of other systems and organs. The elevated titer of anti-myeloperoxidase ANCA is very important immunological indicator. The main changes in our patient were related to the lung bleeding and rapidly progressive glomerulonephritis. The treatment has started according to the standard Fauci scheme adjusted to the level of disease severity and the age of patient (prednisone 60 mg/24 h, along with the gradual dosage decrease, cyclophosphamide 150 mg/24 h) and has lead to the clinical-laboratory remission. The patient had the leukocyte values irregularly controlled during the immunosuppressive therapy and agranulocytosis thus caused was not spotted in time, leading to the inadequate treatment of pneumonia that brought on the lethal outcome.

[Use of mycophenolate mofetil in patients with a transplanted kidney and cyclosporin nephrotoxicity]. / Primena mikofenolat mofetila kod bolesnika sa presadjenim bubregom i ciklosporinskom nefrotoksicnoscu.

Cyclosporine (CsA) nephrotoxicity is an important problem in renal transplant recipients, which can influence long-term graft survival. The safety of conversion from CsA to azathioprine (AZA) remains controversial and can result in higher incidence of acute rejection. Mycophenolate mofetil (MMF) is a new immunosuppressive agent superior to AZA in the prevention of acute rejection. Five patients with cyclosporine nephrotoxicity were converted from CsA/AZA/prednisolon to MMF/prednisolon protocol. All patients had low immunological risk and 4 out of 5 patients received antithymocyte globulin before conversion as the induction therapy or as the treatment for acute rejection. Mean follow-up after conversion was 16.8 months (range 4-32 months). No patient experienced acute rejection during follow-up period. The mean serum creatinine concentration decreased from 219 +/- 44.18 (range 168-280) to 122.6 +/- 48.02 mumol/l (range 72-187 mumol/l) (p = 0.002). Arterial hypertension improved after CsA withdrawal in 20% of patients. We have concluded that, in selected patients with cyclosporine nephrotoxicity, CsA withdrawal with concomitant use of MMF is safe and effective in the improvement of graft function and arterial hypertension.

[Treatment of chronic viral hepatitis B in secondary membranoproliferative glomerulonephritis using recombinant alfa-2 interferon]. / Lecenje hronicnog virusnog hepatitisa B u sekundarnog membranoproliferativnog glomerulonefritisa rekombinantnim alfa-2 interferonom.

A patient suffering from viral hepatitis B and secondary membranoproliferative glomerulonephritis was presented. He was treated with recombinant alfa-2 interferon. The therapy led to clinical and biochemical remission of the liver and kidney lesions. The example of our patient justifies the use of recombinant alfa-2 interferon in the patients with chronic viral hepatitis B and secondary glomerulonephritis.

Membranoproliferative glomerulonephritis in two siblings: report and literature review.

There is evidence of a genetic basis in some cases of idiopathic membranoproliferative glomerulonephritis (MPGN) types I and III, particularly those occurring in families. The clinical and morphological features and disease course in two siblings with MPGN are described. In the male sibling, both clinical and morphological features as well as serum complement profile suggested type I MPGN; electron microscopy appearance in the female sibling was consistent with type III MPGN. Both patients had treatment-resistant nephrotic syndrome which evolved into renal insufficiency in the girl. No hereditary complement deficiencies were found in siblings or their parents. Both children exhibited HLA-A24; -B27, w4; -DR11, 52; -DQ3 antigens. Between 1981 and 1996, 18 patients from eight families with unequivocal diagnosis of MPGN I or III had been described. The mode of inheritance appeared to be autosomal dominant or X-linked in four of these families. In 11 patients, including our 2, in whom HLA typing was performed, eight had the HLA-A2 antigen. Similarities and discrepancies regarding clinical and morphological features and outcomes were evident in these intrafamilial cases, suggesting either a similar genetic background or a multigenic origin of MPGN. The familial occurrence of the MPGN, highlighted by our report, supports the concept that genetically determined factors may be involved in the pathogenesis of the disease.

Estimation of chronic hepatitis C activity based on ultrastructural changes of hepatocytes.

Seventy four liver bioptic specimens of 66 patients with chronic hepatitis C were analyzed ultrastructurally and by light microscopy. According to histological activity of the disease, the patients were divided in groups with minimal activity (CPHa), mild activity (CPHb-CAHa), and moderate and severe activity (CAHb,c), respectively. The presence of lamelar, simple and complex lipid inclusions in the cytoplasm, as well as the presence of nuclear bodies and morphology of the nucleolus were analyzed by classic methods of transmission electron microscopy. Cytoplasmic lamelar inclusions were found in 84.6% of patients, and simple and complex lipid inclusions were noted in 85.1% of patients, without the differences related to histological and enzyme activity. Unaltered nucleolus was most frequently observed in patients with minimal disease activity (84.6%), viral changed in patients with mild activity (48.4%) and synthetic active in patients with moderate and severe activity (66%). Serum aminotransferase activity was significantly higher in patients with viral changed and synthetic active nucleolus. These results can indicate that HCV induces cytopathogenic and immunologic damage of hepatocytes. The presence of virus acts as toxic agent that damages hepathocytes' metabolism, thus resulting in occurrence of cytoplasmic lamelar, simple and complex lipid inclusions, respectively. Immunologic damages occur when the virus alters cell membrane of hepatocytes.

[Cerebrovascular accidents in Sarajevo during the war]. / Accidents vasculaires cérébraux à Sarajevo pendant la guerre.

PURPOSE: Neurologists in the main hospital in Sarajevo (Bosnia-Herzegovinia), we worked in the neurological department throughout the war and the siege of the town, from 1992/4/6 to 1995/12/15. We report on strokes which happened during that period, comparing stroke incidence and severity in relation to those two years before. We reviewed 3002 cases of stroke recorded in the neurological department registry from 01/01/90 to the end of the war. RESULTS: The activity of the department was reduced by about 40 p. 100, as was the population of the town. Yet the number of strokes decreased only by 26.5 p. 100. The comparative incidence of strokes increased by 25 p. 100 during the war. Sex ratio and age incidence were the same. The relative role of atherosclerosis, cardiac embolic sources, intracranial and meningeal hemorrhage remained the same. The incidence of intracranial hemorrhage increased by 20 p. 100. Death, evaluated after one month, increased by 36 p. 100. Death by intracranial hemorrhage increased by 30 p. 100, those by cardiac embolic infarction by 26 p. 100 and those by atherosclerosis by 20 p. 100. At the end of the first year of the war, mortality was 65 p. 100 in comparison with the previous year and death by meningeal hemorrhage increased by 74 p. 100 for the first two years of the war. The major changes in life conditions have produced change in medical conditions. Patients had to stop their treatment because there was no more medecine in the city, and, among others, no more drugs for anticoagulation, diabetes mellitus, cardiopathy.... In the hospital, medical doctors, nurses, drugs, food and even heating were missing. So stopping the treatment for vascular disease together with the high level of stress generated by daily shelling can explain the increase in stroke incidence and especially, the hemorragic cases. The poor life conditions which weakened people and the lack of treatment at the acute stage of the disease and also later, when secondary events occurred, can explain the high mortality observed. CONCLUSION: We recognize the bias of our study: the war itself, the condition in which we have carried out this work and the use of a hospital registry. Nevertheless, it seems that morbidity not directly due to the battle can change during a war like this one. This study also demonstrates, "a contrario", that preventive treatment and care of stroke at the acute phase, as they are currently recommended, are useful.

L-arginine reduces tubular cell injury in acute post-ischaemic renal failure.

BACKGROUND: The pathophysiology of renal ischaemia, resulting in tubular cell injury and leading to acute renal failure (ARF), remains unclear. An ever-increasing number of investigations focus on a possible role of nitric oxide (NO) in regulating circulation during ARF. In this context, we investigated the influence of chronic stimulation or inhibition of NO synthesis, or both, on haemodynamic parameters, histology and plasma renin activity (PRA) after ischaemia-reperfusion injury of rat kidneys. METHODS: Experiments were performed on adult, male Wistar rats. Before induction of ARF, a group of animals was treated with a NO synthesis inhibitor (L-NAME) and another group was treated with a precursor of NO synthesis (L-arginine). The animals received those substances for 4 weeks. Control groups received the same amount of tap water for 4 or 8 weeks and were divided into groups with ARF (4 weeks--ARF group and 8 weeks ARF group) and a sham-operated group. Another group of rats was treated first with L-NAME and then with L-arginine in their drinking water, for 4 weeks for each of these two substances. All parameters were evaluated 24 h after the induction of ischaemic ARF or the sham operation. RESULTS: Our results show that such long-term stimulation of NO release by L-arginine improved renal haemodynamics in the ischaemic form of ARF. Renal blood flow (RBF) increased by 96% in the L-arginine-treated rats with ARF compared with the group with ARF alone. Inhibition of NO synthesis worsens renal haemodynamics after ARF. However, this aggravation can be reversed by L-arginine. The rate of water reabsorption was reduced in all groups with ARF, but this reduction was least in the group treated with L-arginine. The rate of Na+ reabsorption was reduced in all groups 24 h after renal ischaemia, but a significant decrease was observed after the inhibition of NO synthesis. Histological examination of the kidney specimens showed that morphological changes were least in the rats treated with L-arginine, when compared with all other groups with ARF. Nevertheless, the lesions were most prominent in the L-NAME+ARF group. In this group, the areas of corticomedullar necrosis were more widespread in comparison with other groups, especially the L-arginine group where only swelling of the proximal tubular cells was observed. Treatment with L-NAME was not accompanied by any significant alteration in the plasma concentration of angiotensin I (ANG I), while in the group treated with L-arginine ANG I had a tendency to decrease. CONCLUSIONS: Acute post-ischaemic renal failure may be alleviated by administering the NO substrate (L-arginine). NO acts cytoprotectively on tubular epithelial cells in ischaemia--reperfusion injury of rat kidney. Evidence of this comes from both histopathological findings and increased tubular water and sodium reabsorption. However, inhibition of NO synthesis (provoked by L-NAME) worsens renal haemodynamics and aggravates morphological changes after ARF. These aggravations can, however, be reversed by L-arginine.

[Pulsed doses of cyclophosphamide in the treatment of Wegener's granulomatosis]. / Pulsne doze ciklofosfamida u lecenju Vegenerove granulomatoze.

The aim of the study was to analyze the efficacy and toxicity of the therapy with pulse dose of cyclophosphamide in patients with Wegener's granulomatosis. The diagnosis was established in three patients (2 male, 1 female, average age 58.3 years) upon the clinical picture, laboratory-immunologic and histopathologic findings. The initial therapy was conducted by pulse doses of cyclophosphamide (0.6 and 0.8 g/kg), glucocorticoids (0.5 g), repeated plasmapheresis and pulse doses of immunoglobulin (0.4 g/kg). All patients achieved remission with complete recovery of renal function in one patient. The therapy with pulse doses of cyclophosphamide (time-period between pulses from 1 to 3 months), together with glucocorticoids taken orally for 24 months, was continued for the following 18 months. Stable remission (4-15 months) was maintained in all the patients after the immunosuppressive therapy was over. The treatment of Wegener's granulomatosis by cyclophosphamide and glucocorticoid pulse doses with the application of plasmaphereses and immunoglobulin pulse doses in the initial therapy lead to the remission of progressive types of long duration.

Isolation of a coronavirus from kidney biopsies of endemic Balkan nephropathy patients.

Endemic Balkan nephropathy (EBN) is a kidney disease of unknown etiology limited to Bulgaria, Rumania and former Yugoslavia. Primary kidney tissue cultures were established as explants from tissue obtained at operations from 5 EBN patients with urinary tract tumors. Four out of the five biopsy specimens on extended culture incubation at 33 degrees C yielded a coronavirus virus (EBNV) which was cytopathogenic for human fibroblast and Vero cells. In cells inoculated with EBNV, cytoplasmic immunofluorescence was found using antisera for human coronaviruses OC43 and 229E as well as the porcine transmissible gastroenteric virus and avian (chicken) bronchitis virus. In neutralization tests, EBNV failed to react with antisera to these viruses. Using hyperimmune serum raised with EBNV, positive cytoplasmic immunofluorescence was seen with cells infected with OC43, 229E, TGV and significantly with the kidney tissue of the biopsy specimens from the EBN patients. A screen for neutralizing antibody using the EBN virus revealed that 87.2% of EBN patients on dialysis were positive, also 74% of people from an endemic area were also positive, while only 13.5% from outside were positive. It is suggested that a coronavirus is involved in the etiology of the disease and that humans are an incidental host of a coronavirus zoonosis.

[Urticarial vasculitis--a syndrome with low complement levels and secondary glomerulopathy]. / Urtikarija vaskulitis--sindrom sa niskim vrednostima komplementa i sekundarnom glomerulopatijom.

In female patient, aged 41, 3 years ago appeared skin changes of urticarial type, and occasional pain in the joints of shoulders and hands, followed by complete weakness and exhaustion, as well as the occurrence of face and eyelid edema. Laboratory findings confirmed the presence of hypocomplentemia with proteinuria, microhematuria and cylindruria. Histopathologic (HP) finding of skin biopsy was leukocytoclastic vasculitis, and HP finding of the kidneys was mesangioproliferative glomerulonephritis. The regression of skin changes was observed during hospitalization after Dapsone was administered. The therapy started with corticosteroids (Prednisone 40 mg/day with weekly dose from 5 mg to 30 mg). In spite of the therapy, hypocomplementemia and proteinuria up to 335 mg/24 h have maintained for a year in the later controls in an outpatient department. The patient is without discomfort, and renal function is stable.

[Significance of inflammatory cytokines in the pathogenesis of IgA nephropathy]. / Znacaj inflamacijskih citokina u patogenezi IgA nefropatije.

Prospective study was performed on the concentrations of inflammatory cytokines IL-1, TNF and IL-6 in serum and urine (ELISA tests) were determined in the scope of total clinical-laboratory and histologic treatment in 59 patients with primary IgA nephropathy. Control group consisted of 20 healthy subjects. IL-6 was not detected either in serum of patients with IgAN, or in control examinees. TNF alpha and IL-1 beta were detected in control patients' sera and in patients with IgAN, but detected concentrations were not significantly different. IL-1 beta in urine was detected in 82.8%, TNF alpha in 90.0%, and IL-6 in 40% of our patients with IgAN. The concentrations of IL-1 beta were significantly higher compared to IL-1 beta concentrations in urine of healthy subjects and significantly correlated with the severity of glomerular and tubulointerstitial changes, as well as with the degree of proteinuria. Direct and indirect toxicity of TNF alpha on renal structures was confirmed in significantly higher concentrations of that cytokine in urine of patients with mesangial sclerosis of different percentage compared to the patients with isolated mesangial hypercellularity. Also in the patients with index of chronic lesion over 7 significantly higher TNF alpha concentrations in urine were found compared to the patients with lesion index 0-3 and 4-7. Creatinine clearance was in negative correlation with TNF alpha concentrations in urine of our patients with IgAN. Concentrations of IL-6 in urine were in correlation neither with laboratory parameters of renal function, nor with the degree of histologic changes.

Treatment of IgA nephropathy with nephrotic syndrome using pulse doses of IgG.

This paper presents the preliminary results of the treatment of nephrotic syndrome in IgA nephropathy (IgAN) using pulse doses of IgG. Diagnosis was established only by percutaneous ultrasonically-guided renal biopsy, as well as on the basis of typical immunofluorescence and light microscopy findings. Histopathologic changes were classified according to the World Health Organization classification for IgAN, by determination of average glomerular, vascular and interstitial fibrosis indices and the degree of tubular atrophy. IgG therapy was administered in three patients with nephrotic syndrome associated with IgAN characterized by minimal histological changes, i.e., by diffuse mesangioproliferative glomerulonephritis. Initial IgG pulse dose was 0.4 g/kg, given as slow intravenous infusion during three consecutive days in the course of the three-month period. Maintenance therapy consisted of intramuscular IgG in the doses of 2.5 g twice a month, for the next three months. After a six-month treatment, clinical and biochemical remission was achieved in patients with minimal histologic changes, but in other two patients with diffuse mesangioproliferative glomerulonephritis, the effect of the therapy consisted of reduced proteinuria by more than 50%, with the renal function restored to the level before therapy. Transient increase in the serum creatinine level was found in two patients. These preliminary results with IgG pulse therapy, although obtained on a small number of patients, suggest the drug's potent immunomodulatory properties, but its complexity and levels of actions should be further investigated.

Effects of captopril on morphologic changes in kidney of spontaneously hypertensive rats with adriamycin nephropathy.

Antihypertensive therapy has been shown to slow down the progression of chronic renal failure. Angiotensin converting enzyme inhibitors and calcium antagonists have been emphasized as the agents with the most protective effect. Our previous study showed that captopril slowed down renal function deterioration in the early course of adriamycin (ADR) nephropathy in spontaneously hypertensive rats (SHR). The present study was undertaken with the aim to examine morphologic changes associated with that slower renal function deterioration. Adult (24 weeks) female SHR were randomly divided into the following groups: the control group (n = 12) was given tap water to drink; the adriamycin (ADR) group (n = 25) was treated with ADR; the ADR-captopril (ADR-C) group (n = 27) was treated with ADR and thereafter with captopril (60 mg/kg/day). Rats were sacrificed at weeks 6, 12 and 18 and histologic analysis was semiquantitatively performed. In the control group the glomeruli exhibited only minor changes at the end of the study. In the ADR group slight glomerular mesangial hypercellularity appeared in the sixth week and progressed in focal and segmental sclerosis. Some glomeruli showed segmental proliferation and increased fibrular matrix of a tuft adherent to a fibrocellular crescents. In the ADR-C group, glomeruli with a slight increase of mesangial matrix were seen at the end of the sixth week, mesangial hypercellularity developed until the end of the sixth week, mesangial hypercellularity developed until the end of the 12th week and segmental glomerulosclerosis until the end of the study. Semiquantitative analysis revealed that the mean semiquantitative scores for mesangial expansion and glomerular sclerosis were significantly lower in ADR-C group than in ADR group throughout the study. We concluded that captopril slowed down mesangial expansion and reduced the development of glomerular sclerosis.